Provider Demographics
NPI:1366522534
Name:DUNN, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 W LANCASTER AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3415
Mailing Address - Country:US
Mailing Address - Phone:610-527-2469
Mailing Address - Fax:610-527-1915
Practice Address - Street 1:780 W LANCASTER AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3415
Practice Address - Country:US
Practice Address - Phone:610-527-2469
Practice Address - Fax:610-527-1915
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0361201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice